The role of affective temperaments and chronotype in pharmacotherapy response in patients with obsessive-compulsive disorder

Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1

PURPOSE

This study aimed to explore the associations between homocysteine, rumination, affective temperaments, clinical features, and hopelessness in bipolar disorder-1 (BD-1).

MATERIALS AND METHODS

In total, 57 euthymic patients with BD-1 and 57 healthy controls were included. The Beck Hopelessness Scale (BHS), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Ruminative Responses Scale Short Form (RRS-SF) were administered. Homocysteine, folate, and vitamin B12 levels were measured.

RESULTS

The BHS total (p = 0.047), TEMPS-A irritable (p = 0.007), and TEMPS-A cyclothymic (p= 0.001) scores were significantly higher than the control group in the BD-1 group. Hyperhomocysteinemia (HHcy) was found in 33.3% of the patients (n = 19). In the HHcy group, age of onset of disease (p = 0.020) was significantly lower than the non-HHcy group in patients. Previous suicide attempt number was significantly correlated with scores of reflective pondering, brooding, and global rumination in BD-1 (p ˂ 0.05). Except for hyperthymic temperament, all types of affective temperaments were correlated with the scores of RRS-SF brooding (p ˂ 0.05) in the BD-1 group. The RRS-SF brooding scores significantly correlated with the BHS total scores (r = 0.263, p < 0.05); the TEMPS-A hyperthymic (β = -0.351, p = 0.001) and TEMPS-A irritable (β = 0.536, p < 0.001) scores significantly predicted the BHS total scores in the BD-1 group.

CONCLUSIONS

The findings may lead clinical efforts and future clinical trials to explore and intervene in related sources and presentations of BD-1's adverse consequences.

Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment

Delays in behavioral and biological circadian rhythms (e.g., sleep timing, melatonin secretion) are found more frequently in individuals with severe and treatment-resistant obsessive-compulsive disorder (OCD). In recent years, it has been documented that these delays in behavioral and biological circadian rhythms are associated with more severe OCD symptoms and poorer response to some OCD treatments. This study examined self-reported sleep behaviors in individuals taking part in an intensive treatment for OCD and the relations between these and OCD symptoms (both at admission to and discharge from the treatment program). Replicating previous findings in less severe populations, delayed sleep phases were relatively common in this group and later bedtimes were associated with more severe OCD symptoms at admission. Sleep onset latency and sleep duration were not associated with OCD symptom severity at admission. Later bedtimes were not associated with self-reported depression or worry symptom severity. There was no evidence of sleep behaviors affecting change in OCD symptoms from admission to discharge from treatment-however, later bedtimes at admission were associated with more severe OCD symptoms at admission and discharge from treatment. There was no evidence of sleep onset latency or sleep duration having a similar predictive effect. More severe OCD symptoms at admission were also associated with later bedtimes at admission and discharge from treatment. These bidirectional predictive relations between late bedtimes and OCD symptoms were of small effect size but support the potential value of evaluating sleep timing in individuals with severe and/or treatment-resistant OCD.

The course and clinical correlates of obsessive-compulsive disorder during the postpartum period: A naturalistic observational study

BACKGROUND

In this study, we aimed to investigate the course of obsessive-compulsive disorder (OCD) and the demographic and clinical correlates associated with significant changes in symptom severity in postpartum women.

METHODS

Data were collected form 37 consecutive postpartum women who were diagnosed with OCD during psychiatric interviews by means of the Structured Clinical Interview for DSM-IV (SCID-I). Psychiatric assessments were carried out on the first day after delivery and at 6 to 8 weeks in the postpartum period. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was administered at both assessments while the Hospital Anxiety and Depression Scale (HADS), Coping orientation to problems Experienced (COPE) and Multidimensional Scale of Perceived Social Support (MSPSS) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), were administered to the participants at the first assessment.

RESULTS

The mean score of Y-BOCS was significantly reduced from the baseline to the 6-8 week postpartum period. The proportion of patients with a decreaseof at least 35% in the total score of Y-BOCS during the postpartum period was 43.2%. When the patient groups with and without ≥35% decrease in the total score of Y-BOCS were compared, the group showing the decrease had a higher score of COPE-supression of competing activities, COPE-humor and TEMPS-A-hyperthymic affective temperament and more frequently reported a decrease in the severity of OCD symptoms after a previous childbirth. Logistic regression analysis indicated that the last two variables could accurately predict a ≥ 35 decrease in the severity of OCD symptoms during the postpartum period.

LIMITATIONS

The study has relatively small sample size.

CONCLUSIONS

The current results suggest that patients with OCD who exhibit hyperthymic affective temperament character and a decrease in symptoms following a previous childbirth may experience a significant alleviation in the severity of obsessive-compulsive symptoms during the postpartum period.

Circadian Rhythms in Obsessive-Compulsive Disorder: Recent Findings and Recommendations for Future Research

PURPOSE OF REVIEW

Circadian rhythms are a topic of growing interest in mental health, particularly in obsessive-compulsive disorder. However, the consistency of this link has not been carefully examined. Thus, the present review integrates findings from the past 5 years in order to determine the strength of such a relationship and identify areas for clarification and extension.

RECENT FINDINGS

Findings revealed inconsistent evidence for a link between circadian rhythms and OCD. Chronotype is unrelated to OCD symptoms in adolescents but predicts OCD symptoms in adults. Results on delayed sleep timing are equivocal. Circadian rhythm disorders predict OCD treatment outcome. Preliminary evidence implicates decreased light exposure and diurnal symptom variability in OCD. The relationship between circadian rhythms and OCD may vary by age, diagnostic status, and assessment method. Recent findings are limited by an overreliance on convenience samples and singular self-report methods. Recommendations for future research on the role of circadian rhythms in OCD are discussed.